Modernizing Medicaid: Putting Home and Community-Based Services on Equal Footing with Nursing Homes

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October 30, 2013
Senate Russell Office Building, Room 325

This forum explored modernizing Medicaid to enable people who need long-term services and supports (LTSS) to live where they choose, including their own homes and communities. The discussion comes at a time of growing bipartisan support for changing Medicaid’s requirement to fund LTSS in nursing homes while funding home and community-based services (HCBS) are funded only on a limited and optional basis. In addition to restricting choice, the half-century old provision makes it difficult to meet a growing demand for LTSS in a cost-effective way.

The recent federal Commission on Long-Term Care called for building a system that promotes “services for persons with functional limitations in the least restrictive setting appropriate to their needs.” A major step toward accomplishing this goal would be to reform Medicaid to put coverage for HCBS on par with coverage for nursing homes. Speakers at this event discussed policy options for accomplishing this reform and lessons learned in individual states.